Hello Doctor -- I am HIV+ (12 years), relatively healthy, never been on antiretrovirals (CD4 around 650, last viral load 55,000). In September, at age 49, my partner had active shingles. I got chicken pox, which I had assumed I had as a child. My doctor gave me Famvir, and the chicken pox went away, but I can't seem to fully recover. It's now been six weeks since I finished the Famvir, which I took faithfully three times per day for seven days, but as yet I have very little appetite, have lost nearly thirty pounds, am so tired I can hardly get up in the morning, and still feel like throwing up quite often after I DO force myself to eat. I went back to my doctor and told him I was concerned that it was taking so long to get over this stuff, and he said at my great age it would just take quite a while to recover. I am concerned that this brought me down immuno-wise to the point that the HIV (or something else) has gotten ahead here. Should I just wait it out? Or should my doctor be looking for other things that might be happening considering my HIV status? I also have Hepatitis C with a Hep C viral load of two million, which he says is not to worry about. Lastly I have no spleen since it was removed in 1995 due to extremely low platelet counts. Thank you so much.

Response from Dr. Feinberg

I think it would be useful to have your T helper cell count and both HIV and hepatitis C viral loads rechecked, and to consider going on HIV therapy if these values indicate progressive disease. Any infection or illness that stimulates the immune system, such as chicken pox, can cause increases in HIV viral load, and hepatitis C can also worsen as HIV disease worsens. Good luck!

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